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Evidence-Based Hypertension
  1. Daniel M Panisko, MD, MPH
  1. University Health Network University of Toronto Toronto, Ontario, Canada

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    Figure1

    Mulrow CD, ed. Evidence-Based Hypertension. London: BMJ Books, 2001.

    Evidence-Based Hypertension has successfully achieved its goal to be a “practice-based textbook” that provides primary care practitioners with an evidence-based approach to the management of hypertension. The authors have also succeeded admirably in achieving their secondary goal of providing patient-centered approaches.

    The almost pocket-sized handbook is clearly organised with chapters whose titles frame the vital questions in hypertension management. An opening chapter orients readers to the book's purpose, philosophy, and style. Diagnosis of hypertension, impact of cardiovascular risk factors, treatment of hypertension, integration of management with comorbid conditions, continuing care, difficult clinical situations, and hypertension in pregnancy are all comprehensively discussed.

    Each chapter is prefaced with subheading questions that allow for a quick scan of content and organisation. Future editions would benefit from the subheadings being included in the table of contents. Text boxes with salient points clearly and concisely present relevant concepts. Patient cases, incorporated into each chapter, emphasise typical and controversial aspects of care. These “patient notes” give a concrete and anecdotal anchor that some readers will appreciate because they highlight and illustrate diagnostic and therapeutic practices and dilemmas. In many sections of the book, further emphasis is placed on the role that patients can take in their own care. Summary “bottom lines” at the conclusion of each chapter, organised as short bulleted points of prose, allow for reinforcement of concepts at the end of a thorough read, for revision at a future date, or for quick reference at any time.

    The evidence supporting the authors' recommendations in each section of the book is clearly defined. This definition is uniform in terms of its quality and is clearly delineated in the opening chapter. Its incorporation into the text of each chapter is far from oppressive, and the prose still flows fluently without compromising readability. The methods for the literature searches for each section are also clearly defined at the end of each chapter, and extensive up-to-date references are listed. The authors present an authoritative review of their topics and address the critical clinical questions in each. The approach is fresh, with consistent reference to and new examination of the primary research, in contrast to the use of many existing opinion-based practice guidelines.

    Evidence-Based Hypertension is useful to practitioners who desire an authoritative and comprehensive cover-to-cover read to revise and update a vital topic in primary care practice. Because the book is clearly organised, it is useful as a quick resource to answer immediate practice-based questions as they arise. Its small size and portability suggest it will be an often used, desk reference text.

    This short textbook is not only important for the excellent coverage of its chosen topic and its practical utility for the clinician. It should also be cited as an ideal model of its genre. Its careful and consistent format allows multiple authors to deliver information clearly and effectively. The book incorporates rational and feasible methodological standards of evidence-based writing. These characteristics lead to a highly readable presentation and style without the undue heavy weight of academic writing. Evidence-Based Hypertension sets a high standard that merits emulation.

    Ratings:

    Clinical usefulness: ★★★★★

    Methods/Quality of information: ★★★★★

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